Nurses vs. Doulas vs. Midwives: Who's Who

The right doula, midwife or nurse can play a major role in helping you have an ideal labor & birth. Here, a quick guide to who to expect & want in the delivery room.

Nurses vs. Doulas vs. Midwives: Who's Who in the Delivery Room Tyler Olson/Shutterstock

When it comes time to push out your baby, you'll be doing all the hard work, Mama—but there are plenty of people who can help you along the way. Your partner, of course, can hold your hand and wipe your sweaty brow during delivery, and your OB (if you choose to use one) will take care of your medical needs. But here are some other people who might be part of your D-Day team.

Nurse-Midwife

Midwife-assisted births have been on the rise in the last few decades—and they've gotten a great pop-culture boost recently with the PBS series Call the Midwife, about heroic baby-catchers in postwar London. Today, roughly 8 percent of all American births are attended by these highly skilled women (and, yes, a handful of men). Though midwives are the go-to health care providers for women who choose to deliver at home or in a freestanding childbirth center, 95 percent of all the births they assist take place in hospitals. Midwives will handle all your prenatal care, and will deliver your baby with as few medical interventions as possible. They often work in collaboration with an MD, and may call one in if complications arise; otherwise, they handle low-risk births from start to finish. "The hallmark of midwifery is we help women be informed and active participants in their care," says Eileen E. Beard, CNM, senior practice advisor for the American College of Nurse-Midwives.

You might hire one if... You're interested in a more holistic relationship between health care provider and patient; if you have a low-risk pregnancy and you're hoping to deliver with as few medical interventions (such as induction and epidural) as possible; and if you look at childbirth as healthy and natural rather than a medical event. "I had painful back labor and I was fighting against it instead of working through it," recalls Michelle Stoutenburgh, 37, of Gilbert, Ariz. "My midwife kept reassuring me that was about 15 minutes away from holding my baby, and sure enough, once I got in that mindset, my water broke and my son arrived a few minutes later. My team of midwives were absolute angels and I am forever indebted to them."

The 411: Certified nurse-midwives (CNMs) are R.N.s who have graduate training in midwifery and are licensed to practice in all 50 states (other types of midwives, such as Certified Practical Midwives or direct-entry midwives go through different training, may not have college degrees, and are more likely to assist out-of-hospital births). CNMs should be covered by your insurance as a primary-care provider or specialist, and you can start looking as soon as you're even thinking about getting pregnant, since they handle well-woman care as well. Find one by asking friends and doctors for referrals or checking out the "Find a Midwife" feature at Midwife.org.

Doula

A doula does not deliver your baby—that's the job of your OB or midwife. She's there to support you emotionally and physically through your entire labor. She'll help you create a birth plan (and advocate for it when you're too exhausted, dazed, or in pain to speak up for yourself), rub your back, suggest the best positions for pain relief, fix you a snack, bring you to the hospital or birth center, and give your partner ideas for how he can best be there for you.

You might hire one if... You'd like one-on-one help from someone who's been trained in all the stages of labor and will stay with you throughout your entire labor.

The 411: Ask your friends for recommendations, or search the "Find a Doula" database at DONA.org (though anyone can call themselves a doula, the 11,000 doulas certified by Doulas of North American have all been through a rigorous training and certification process). If possible, start interviewing doulas in your second trimester, so you can find one you really click with, suggests Sunday Tortelli, president of DONA. You'll probably meet a couple of times before your due date to get to know each other and go over your birth plan. Since doulas are not health care providers, they are generally not covered by insurance, but you may be able to apply for reimbursement under your health savings plan. Rates vary depending on your location and the doula's experience, but expect anywhere from "a few hundred dollars to over $1,000," says Tortelli.

Labor & Delivery Nurse

If you deliver with an OB in a hospital setting, you'll likely spend a lot more time with the nurses than with your doctor (especially if you have a long labor). They will be the ones monitoring your vital signs, checking on the baby, helping you get up and go to the bathroom, and generally taking care of you while you labor. You don't have a choice of who you get—it all depends on who's on duty. Though your relationship with your team of nurses will likely end the minute you leave the labor & delivery ward, they can be your best friends for the time you spend there. "I had an amazing nurse who was 70, wore a tool belt, and talked me through the whole experience," says Georgie Bishop, 35, of Telluride, Colo. "She was my guardian angel throughout the birth."

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